切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2020, Vol. 09 ›› Issue (02) : 115 -121. doi: 10.3877/cma.j.issn.2095-3224.2020.02.002

所属专题: 文献 指南共识

指南与共识

中国结直肠癌卵巢转移诊疗专家共识(2020版)
中国医师协会结直肠肿瘤专业委员会   
  • 收稿日期:2020-03-29 出版日期:2020-04-25
  • 基金资助:
    北京市科技计划(No.D171100002617004); 中国医学科学院医学与健康科技创新工程项目(No.2016-I2M-1-001)

Chinese experts consensus on the management of ovarian metastases from colorectal cancer (2020 version)

Colorectal Cancer Committee of Chinese Medical Doctor Association.   

  • Received:2020-03-29 Published:2020-04-25
  • About author:
    Corresponding author: Wang Xishan, Email:
引用本文:

中国医师协会结直肠肿瘤专业委员会. 中国结直肠癌卵巢转移诊疗专家共识(2020版)[J]. 中华结直肠疾病电子杂志, 2020, 09(02): 115-121.

Colorectal Cancer Committee of Chinese Medical Doctor Association.. Chinese experts consensus on the management of ovarian metastases from colorectal cancer (2020 version)[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(02): 115-121.

我国结直肠癌发病率和死亡率位于恶性肿瘤前五位。卵巢转移作为女性结直肠肿瘤患者相对少见的转移部位,其症状隐匿、进展迅速,对于常规化疗敏感性欠佳,临床治疗选择存在争议。因此,在中国医师协会结直肠肿瘤专业委员会的组织下,国内相关领域权威专家共同制定《中国结直肠癌卵巢转移诊疗专家共识》,以规范结直肠癌卵巢转移患者的诊疗流程,从而提高我国结直肠肿瘤的整体诊治水平,延长结直肠癌患者生存时间,改善生活质量。

Colorectal cancer is one of the major causes of morbidity and mortality in China. Ovarian metastasis from primary colorectal cancer is an uncommon condition for female patients. With insidious symptoms and poor sensitivity to conventional chemotherapy, the clinical treatment of ovarian metastasis remains controversial. Therefore, experts from Chinese Colorectal Cancer Committee developed "Chinese experts consensus on the management of ovarian metastases from colorectal cancer", which aims to standardize the diagnosis and treatment of patients with colorectal cancer ovarian metastases, improve the quality of management, prolong the survival, as well as improve the quality of life.

图1 同时性卵巢转移的诊疗流程
图2 异时性卵巢转移的诊疗流程
中国结直肠癌卵巢转移诊疗专家共识(2020版)讨论专家名单:
编写组组长
? 王锡山 中国医学科学院肿瘤医院
? 孙 力 中国医学科学院肿瘤医院深圳医院
? 崔书中 广州市肿瘤医院
? 许剑民 复旦大学附属中山医院
? 韩方海 中山大学附属孙逸仙纪念医院
? 李 斌 中国医学科学院肿瘤医院
共识执笔人
? 刘 正 中国医学科学院肿瘤医院
? 胡茜玥 中国医学科学院肿瘤医院
共识参编人员(拼音顺序排列)
? 陈瑛罡 中国医学科学院肿瘤医院深圳医院
? 程海东 内蒙古医科大学附属医院
? 邓艳红 中山大学附属第六医院
? 樊敬文 香港大学深圳医院
? 黄炯强 广州医科大学附属第一医院
? 姜 军 中国医学科学院肿瘤医院
? 蒋飞照 温州医科大学附属第一医院
? 鞠海星 浙江省肿瘤医院
? 李其云 江西省肿瘤医院
? 刘少军 安徽省立医院
? 刘天伯 哈尔滨医科大学附属肿瘤医院
? 刘 忠 深圳大学总医院
? 罗德红 中国医学科学院肿瘤医院深圳医院
? 吕国庆 北京大学深圳医院
? 彭 健 中南大学湘雅医院
? 邰智慧 华北理工大学附属医院
? 吴小剑 中山大学附属第六医院
? 夏利刚 深圳市人民医院
? 许建萍 中国医学科学院肿瘤医院
? 许庆文 广东医科大学附属医院
? 燕 速 青海大学附属医院
? 姚学清 广东省人民医院
? 易 波 江西省肿瘤医院
? 张 涛 粤北人民医院
? 张谢夫 郑州大学第一附属医院
? 张 逸 苏州大学附属第一医院
? 赵 丹 中国医学科学院肿瘤医院
? 郑智海 温州医科大学附属第一医院
? 郑宗珩 中山大学附属第三医院
? 曾祥福 赣南医学院第一附属医院
? 邹霜梅 中国医学科学院肿瘤医院
[1]
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015 [J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[2]
Byun JH, Ahn JB, Kim SY, et al. The impact of primary tumor location in patients with metastatic colorectal cancer: a Korean Cancer Study Group CO12-04 study [J]. Korean J Intern Med, 2019, 34(1): 165-177.
[3]
Segelman J, Floter-Radestad A, Hellborg H, et al. Epidemiology and prognosis of ovarian metastases in colorectal cancer [J]. Br J Surg, 2010, 97(11): 1704-1709.
[4]
Hanna NN, Cohen AM. Ovarian neoplasms in patients with colorectal cancer: understanding the role of prophylactic oophorectomy [J]. Clin Colorectal Cancer, 2004, 3(4): 215-222.
[5]
Garrett CR, George B, Viswanathan C, et al. Survival benefit associated with surgical oophorectomy in patients with colorectal cancer metastatic to the ovary [J]. Clin Colorectal Cancer, 2012, 11(3): 191-194.
[6]
Erroi F, Scarpa M, Angriman I, et al. Ovarian metastasis from colorectal cancer: prognostic value of radical oophorectomy [J]. J Surg Oncol, 2007, 96(2): 113-117.
[7]
Kim DD, Park IJ, Kim HC, et al. Ovarian metastases from colorectal cancer: a clinicopathological analysis of 103 patients [J]. Colorectal Dis, 2009, 11(1): 32-38.
[8]
Fujiwara A, Noura S, Ohue M, et al. Significance of the resection of ovarian metastasis from colorectal cancers [J]. J Surg Oncol, 2010, 102(6): 582-587.
[9]
Tan KL, Tan WS, Lim JF, et al. Krukenberg tumors of colorectal origin: a dismal outcome--experience of a tertiary center [J]. Int J Colorectal Dis, 2010, 25(2): 233-238.
[10]
Ojo J, De Silva S, Han E, et al. Krukenberg tumors from colorectal cancer: presentation, treatment and outcomes [J]. Am Surg, 2011, 77(10): 1381-1385.
[11]
Mori Y, Nyuya A, Yasui K, et al. Clinical outcomes of women with ovarian metastases of colorectal cancer treated with oophorectomy with respect to their somatic mutation profiles [J]. Oncotarget, 2018, 9(23): 16477-16488.
[12]
Xu KY, Gao H, Lian ZJ, et al. Clinical analysis of Krukenberg tumours in patients with colorectal cancer-a review of 57 cases [J]. World J Surg Oncol, 2017, 15(1): 25.
[13]
Chung TS, Chang HJ, Jung KH, et al. Role of surgery in the treatment of ovarian metastases from colorectal cancer [J]. J Surg Oncol, 2009, 100(7): 570-574.
[14]
Ganesh K, Shah RH, Vakiani E, et al. Clinical and genetic determinants of ovarian metastases from colorectal cancer [J]. Cancer, 2017, 123(7): 1134-1143.
[15]
Sekine K, Hamaguchi T, Shoji H, et al. Retrospective analyses of systemic chemotherapy and cytoreductive surgery for patients with ovarian metastases from colorectal cancer: A single-center experience [J]. Oncology, 2018, 95(4): 220-228.
[16]
Goere D, Daveau C, Elias D, et al. The differential response to chemotherapy of ovarian metastases from colorectal carcinoma [J]. Eur J Surg Oncol, 2008, 34(12): 1335-1339.
[17]
Omranipour R, Abasahl A. Ovarian metastases in colorectal cancer [J]. Int J Gynecol Cancer, 2009, 19(9): 1524-1528.
[18]
Lee SJ, Lee J, Lim HY, et al. Survival benefit from ovarian metastatectomy in colorectal cancer patients with ovarian metastasis: a retrospective analysis [J]. Cancer Chemother Pharmacol, 2010, 66(2): 229-235.
[19]
Kir G, Gurbuz A, Karateke A, et al. Clinicopathologic and immunohistochemical profile of ovarian metastases from colorectal carcinoma [J]. World J Gastrointest Surg, 2010, 2(4): 109-116.
[20]
Shariff U, Seretis C, Youssef H. Management of colorectal cancer patients at high risk of peritoneal metastases [J]. J Buon, 2015, 20(Suppl 1): S71-79.
[21]
Lewis MR, Deavers MT, Silva EG, et al. Ovarian involvement by metastatic colorectal adenocarcinoma: still a diagnostic challenge [J]. Am J Surg Pathol, 2006, 30(2): 177-184.
[22]
苏继莲,唐黎晶,应伟雯. 卵巢转移癌的超声图像特征 [J]. 中国医学影像学杂志,2009,17(2):111-113.
[23]
Stukan M, Alcazar JL, Gębicki J, et al. Ultrasound and clinical preoperative characteristics for discrimination between ovarian metastatic colorectal cancer and primary ovarian cancer: A case-control study [J]. Diagnostics(Basel, Switzerland), 2019, 9(4): E210.
[24]
Liu F, Gao Z, Shen D, et al. Significance of SATB2 expression in colon cancer and its differential diagnosis in digestive tract adenocarcinoma and ovarian primary and metastatic carcinoma [J]. Pathol Res Pract, 2019, 215(7): 152430.
[25]
Moh M, Krings G, Ates D, et al. SATB2 expression distinguishes ovarian metastases of colorectal and appendiceal origin from primary ovarian tumors of mucinous or endometrioid type [J]. Am J Surg Pathol, 2016, 40(3): 419-432.
[26]
Yamaguchi T, Takahashi H, Kagawa R, et al. The role of prophylactic bilateral oophorectomy at the time of initial diagnosis of a unilateral ovarian metastasis in cases with colorectal adenocarcinoma [J]. Hepatogastroenterology, 2008, 55(82-83): 434-437.
[27]
Mehta AM, Bignell MB, Alves S, et al. Risk of ovarian involvement in advanced colorectal or appendiceal tumors involving the peritoneum [J]. Dis Colon Rectum, 2017, 60(7): 691-696.
[28]
Evers DJ, Verwaal VJ. Indication for oophorectomy during cytoreduction for intraperitoneal metastatic spread of colorectal or appendiceal origin [J]. Br J Surg, 2011, 98(2): 287-292.
[29]
Eveno C, Goere D, Dartigues P, et al. Ovarian metastasis is associated with retroperitoneal lymph node relapses in women treated for colorectal peritoneal carcinomatosis [J]. Ann Surg Oncol, 2013, 20(2): 491-496.
[30]
Sielezneff I, Salle E, Antoine K, et al. Simultaneous bilateral oophorectomy does not improve prognosis of postmenopausal women undergoing colorectal resection for cancer [J]. Dis Colon Rectum, 1997, 40(11): 1299-1302.
[31]
Omranipour R, Abasahl A. Ovarian metastases in colorectal cancer [J]. Int J Gynecol Cancer, 2009, 19(9): 1524-1528.
[32]
Cutait R, Lesser ML, Enker WE. Prophylactic oophorectomy in surgery for large-bowel cancer [J]. Dis Colon Rectum, 1983, 26(1): 6-11.
[33]
Liang JT, Lai HS, Wu CT, et al. Laparoscopic prophylactic oophorectomy plus N3 lymphadenectomy for advanced rectosigmoid cancer [J]. Ann Surg Oncol, 2007, 14(7): 1991-1999.
[34]
Honore C, Goere D, Souadka A, et al. Definition of patients presenting a high risk of developing peritoneal carcinomatosis after curative surgery for colorectal cancer: a systematic review [J]. Ann Surg Oncol, 2013, 20(1): 183-192.
[35]
Honore C, Gelli M, Francoual J, et al. Ninety percent of the adverse outcomes occur in 10% of patients: can we identify the populations at high risk of developing peritoneal metastases after curative surgery for colorectal cancer? [J]. Int J Hyperthermia, 2017, 33(5): 505-510.
[36]
Leung V, Huang N, Liauw W, et al. High risk features of primary colorectal carcinomas which subsequently undergo peritonectomy [J]. Eur J Surg Oncol, 2016, 42(6): 836-840.
[37]
裴炜. 结直肠癌腹膜转移预防和治疗腹腔用药中国专家共识(V2019) [J/CD]. 中华结直肠疾病电子杂志, 2019, 8(4): 329-335.
[38]
Kuijpers AM, Mehta AM, Aalbers AG, et al. Treatment of ovarian metastases of colorectal and appendiceal carcinoma in the era of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy [J]. Eur J Surg Oncol, 2014, 40(8): 937-942.
[39]
Bignell MB, Mehta AM, Alves S, et al. Impact of ovarian metastases on survival in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal malignancy originating from appendiceal and colorectal cancer [J]. Colorectal Dis, 2018, 20(8): 704-710.
[40]
Elias D, Honore C, Dumont F, et al. Results of systematic second-look surgery plus HIPEC in asymptomatic patients presenting a high risk of developing colorectal peritoneal carcinomatosis [J]. Ann Surg, 2011, 254(2): 289-293.
[41]
Serrano Del Moral A, Perez Viejo E, Manzanedo Romero I, et al. Systematic second-look surgery plus HIPEC in patients without evidence of recurrence, at high risk of carcinomatosis after colorectal cancer resection [J]. Cir Esp, 2018, 96(2): 96-101.
[42]
Kyang LS, Valle SJ, Alzahrani NA, et al. Prevention of peritoneal recurrence in high-risk colorectal cancer and evidence of T4 status as a potential risk factor [J]. ANZ J Surg, 2018, 88(10): 975-981.
[43]
Cortes-Guiral D, Elias D, Cascales-Campos PA, et al. Second-look surgery plus hyperthermic intraperitoneal chemotherapy for patients with colorectal cancer at high risk of peritoneal carcinomatosis: Does it really save lives? [J]. World J Gastroenterol, 2017, 23(3): 377-381.
[44]
Kammar PS, Engineer R, Patil PS, et al. Ovarian metastases of colorectal origin: treatment patterns and factors affecting outcomes [J]. Indian J Surg Oncol, 2017, 8(4): 519-526.
[45]
Ribeiro Gomes J, Belotto M, D'alpino Peixoto R. The role of surgery for unusual sites of metastases from colorectal cancer: A review of the literature [J]. Eur J Surg Oncol, 2017, 43(1): 15-19.
[46]
Kim WY, Kim TJ, Kim SE, et al. The role of cytoreductive surgery for non-genital tract metastatic tumors to the ovaries [J]. Eur J Obstet Gynecol Reprod Biol, 2010, 149(1): 97-101.
[1] 康夏, 田浩, 钱进, 高源, 缪洪明, 齐晓伟. 骨织素抑制破骨细胞分化改善肿瘤骨转移中骨溶解的机制研究[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 329-339.
[2] 中华医学会烧伤外科学分会小儿烧伤学组. 儿童烧伤早期休克液体复苏专家共识(2023版)[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 371-376.
[3] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[4] 王得晨, 杨康, 杨自杰, 归明彬, 屈莲平, 张小凤, 高峰. 结直肠癌微卫星稳定状态和程序性死亡、吲哚胺2,3-双加氧酶关系的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(06): 462-465.
[5] 付佳, 肖海敏, 武曦, 冯涛, 师帅. 年龄校正查尔森合并症指数对腹腔镜结直肠癌围手术期并发症的预测价值[J]. 中华普通外科学文献(电子版), 2023, 17(05): 336-341.
[6] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[7] 张生军, 赵阿静, 李守博, 郝祥宏, 刘敏丽. 高糖通过HGF/c-met通路促进结直肠癌侵袭和迁移的实验研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 21-24.
[8] 李婷, 张琳. 血清脂肪酸代谢物及维生素D水平与结直肠癌发生的关系研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 661-665.
[9] 常剑, 邱峰, 毛郁琪. 摄食抑制因子-1与腹腔镜结直肠癌根治术后肝转移的关系分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 502-505.
[10] 王晓燕, 肖佑, 肖戈, 王真权. 老年结直肠癌肺转移CT特征及高危因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 506-509.
[11] 关旭, 王锡山. 基于外科与免疫视角思考结直肠癌区域淋巴结处理的功与过[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 448-452.
[12] 顾睿祈, 方洪生, 蔡国响. 循环肿瘤DNA检测在结直肠癌诊治中的应用与进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 453-459.
[13] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[14] 范小彧, 孙司正, 鄂一民, 喻春钊. 梗阻性左半结肠癌不同手术治疗方案的选择应用[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 500-504.
[15] 静脉淋巴功能不全临床专家共识编写组. 静脉淋巴功能不全临床专家共识[J]. 中华临床医师杂志(电子版), 2023, 17(06): 630-638.
阅读次数
全文


摘要